Association Between Gout and Incident Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Tung, Yi‐Ching; Lee, Su-Shin; Tsai, Wen‐Chan; Lin, Gau-Tyan; Chang, Hsin-Wen; Tu, Hung-Pin

doi:10.1016/j.amjmed.2016.06.041

Cited by 32 publications

(31 citation statements)

References 42 publications

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“…Gout and high levels of UA are associated with increased incidence of several health comorbidities, including CVD [ 8 ], chronic kidney disease [ 21 ], and T2DM [ 22 , 23 ]. Since we did not obtain patients' UA laboratory data, we could not determine whether the UA levels following ULT influenced T2DM development.…”

Section: Discussionmentioning

confidence: 99%

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study

Fang

Chung

Lin

et al. 2020

BioMed Research International

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Gout is the most prevalent inflammatory arthritis in adults. Although the link between gout and type 2 diabetes mellitus (T2DM) has been documented, our understanding of the association between urate-lowering therapy (ULT) among gout patients and T2DM development remains poor. We included 69,326 patients with new-onset gout in 2000-2011. Each case was matched randomly with 1 patient without gout during the study period, and 69,326 patients were recognized as the comparison cohort. A Cox proportional hazard regression model was used to analyze differences in the risk of T2DM development between patients with and without gout after considering related comorbidities. After adjusting for potential confounders, the case group had a higher risk of T2DM than the control cohort (adjusted hazard ratio aHR=1.30, 95%confidence interval CI=1.24-1.38; P<0.001). Gout patients without appropriate ULT had significantly higher risk of T2DM development than the control cohort (aHR=1.39; 95%CI=1.30-1.48; P<0.001). Among gout patients, those receiving ULT excluding probenecid (aHR=0.80; 95%CI=0.64-1.00), all had significantly lower risk of T2DM than gout patients without ULT (all aHR<0.90; all P<0.001). In this study, we found that gout increased the risk of T2DM; however, patients with any ULT exhibited a lower risk of T2DM than gout patients without any ULT (all aHR<0.90, P<0.001; excluding probenecid).

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Section: Discussionmentioning

confidence: 99%

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study

Fang

Chung

Lin

et al. 2020

BioMed Research International

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“…42 This is a clinically significant result because there is also evidence that gout is associated with an increased risk of diabetes. 43,44…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Statins as Primary Prevention in People With Gout: A Population-Based Cohort Study

García-Gil

Comas-Cufí

Ramos

et al. 2019

J Cardiovasc Pharmacol Ther

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Background: Cardiovascular guidelines do not give firm recommendations on statin therapy in patients with gout because evidence is lacking. Aim: To analyze the effectiveness of statin therapy in primary prevention of coronary heart disease (CHD), ischemic stroke (IS), and all-cause mortality in a population with gout. Methods: A retrospective cohort study (July 2006 to December 2017) based on Information System for the Development of Research in Primary Care (SIDIAPQ), a research-quality database of electronic medical records, included primary care patients (aged 35-85 years) without previous cardiovascular disease (CVD). Participants were categorized as nonusers or new users of statins (defined as receiving statins for the first time during the study period). Index date was first statin invoicing for new users and randomly assigned to nonusers. The groups were compared for the incidence of CHD, IS, and all-cause mortality, using Cox proportional hazards modeling adjusted for propensity score. Results: Between July 2006 and December 2008, 8018 individuals were included; 736 (9.1%) were new users of statins. Median follow-up was 9.8 years. Crude incidence of CHD was 8.16 (95% confidence interval [CI]: 6.25-10.65) and 6.56 (95% CI: 5.85-7.36) events per 1000 person-years in new users and nonusers, respectively. Hazard ratios were 0.84 (95% CI: 0.60-1.19) for CHD, 0.68 (0.44-1.05) for IS, and 0.87 (0.67-1.12) for all-cause mortality. Hazard for diabetes was 1.27 (0.99-1.63). Conclusions: Statin therapy was not associated with a clinically significant decrease in CHD. Despite higher risk of CVD in gout populations compared to general population, patients with gout from a primary prevention population with a low-to-intermediate incidence of CHD should be evaluated according to their cardiovascular risk assessment, lifestyle recommendations, and preferences, in line with recent European League Against Rheumatism recommendations.

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“…◾ The prevalence of gout ranges widely around the world, but it affects between 2% and 4% of adults in higher-income countries, 1 with hyperuricemia affecting ~25% of the population 2 ◾ Gout has been shown to be independently associated with an increased risk of type 2 diabetes, and hyperuricemia has been linked to an increased risk of cardiovascular disease and chronic kidney disease progression [2][3][4] ; studies to determine whether lowering uric acid prevents cardiovascular and renal outcomes have been conducted 5 ◾ Canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, has been shown to decrease the risk of cardiovascular disease, heart failure, and kidney disease in large-scale randomized trials 6,7 ◾ Treatment with canagliflozin also reduces serum urate in patients with type 2 diabetes, 8 with similar effects observed for other SGLT2 inhibitors 9 ; however, it is unknown whether SGLT2 inhibitors protect against gout…”

Section: Introductionmentioning

confidence: 99%

1216-P: The Effects of Canagliflozin on Uric Acid and Gout in Patients with Type 2 Diabetes in the CANVAS Program

Li¹,

Badve²,

Zhou³

et al. 2019

Diabetes

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Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce serum uric acid levels. We investigated the effect of canagliflozin compared to placebo on gout in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. The CANVAS Program randomly assigned 10,142 participants with type 2 diabetes to canagliflozin or placebo. Adverse events and serious adverse events attributed to gout, hyperuricemia or hyperuricosuria were identified and the effects of canagliflozin compared to placebo were estimated by calculating the hazard ratio (HR) and 95% confidence interval (95% CI). Mean serum urate levels at baseline were 348.2 (standard deviation 94.3) µmol/L in the canagliflozin group and 349.8 (97.1) µmol/L in the placebo group. Serum urate levels were 23.2 µmol/L (95% CI: -25.6 to -20.9) lower in the canagliflozin versus placebo group at 6 to 13 weeks after randomization and on average were 23.3 µmol/L (95% CI: -25.4 to -21.3) lower during follow-up. There were 80 individuals who reported gout and 76 who reported hyperuricemia or hyperuricosuria during follow-up. The HR for gout was 0.64 (95% CI: 0.41 to 0.99) in those treated with canagliflozin compared to placebo. The corresponding HR for hyperuricemia or hyperuricosuria was 0.57 (95% CI: 0.36 to 0.90) and the HR for a gout, hyperuricemia or hyperuricosuria event was 0.62 (95% CI: 0.45 to 0.85). Canagliflozin reduced serum urate levels and the risk of adverse events attributed to gout. Disclosure J. Li: Employee; Self; George Institute for Global Health. S.V. Badve: None. Z. Zhou: None. R. Oh: Employee; Self; Janssen Research & Development. M. Lee: Employee; Self; Janssen Research & Development. V. Perkovic: Advisory Panel; Self; AbbVie Inc., Astellas Pharma Inc., AstraZeneca, Baxter, Bayer US, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Durect Corporation, Eli Lilly and Company, Gilead Sciences, Inc., GlaxoSmithKline plc., Janssen Research & Development, Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Pfizer Inc., Pharmalink, Relypsa, Inc., Roche Pharma, Sanofi, Servier, Vitae. Research Support; Self; Australian National Health and Medical Research Council. Other Relationship; Self; AbbVie Inc., Boehringer Ingelheim Pharmaceuticals, Inc., GlaxoSmithKline plc., Janssen Research & Development, Pfizer Inc. D. de Zeeuw: Advisory Panel; Self; Bayer US, Boehringer Ingelheim Pharmaceuticals, Inc., Fresenius Medical Care, Mitsubishi Tanabe Pharma Corporation, Mundipharma. Other Relationship; Self; AbbVie Inc., Bayer US, Janssen Research & Development. K.W. Mahaffey: Consultant; Self; Abbott, Ablynx, Baim Institute, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Cardiometabolic Health Congress, Elsevier, GlaxoSmithKline plc., Medergy, Medscape, Mitsubishi Tanabe Pharma Corporation, MyoKardia, Inc., Novo Nordisk Inc., Ocleuve, Portola Pharmaceuticals, Inc., Radiometer America, Springer Publishing, Theravance, UCSF. Research Support; Self; Afferent, Amgen Inc., Apple, Cardiva Medical, Inc, Daiichi, Ferring Pharmaceuticals, Google, Luitpold Pharmaceuticals, Inc., Medtronic, Sanofi, St.Jude, Tenax. Stock/Shareholder; Self; BioPrint Fitness. Other Relationship; Self; AstraZeneca, Johnson & Johnson, Merck & Co., Inc., National Institutes of Health, Novartis Pharmaceuticals Corporation. G. Fulcher: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Research & Development, Merck Sharp & Dohme Corp., Novo Nordisk Inc. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Research & Development, Merck Sharp & Dohme Corp., Novo Nordisk Inc. Research Support; Self; Novo Nordisk Inc. D.R. Matthews: Advisory Panel; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Sanofi, Servier. Consultant; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Servier. Research Support; Self; Janssen Research & Development. Speaker's Bureau; Self; Aché Laboratories, Janssen Research & Development, Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Sanofi, Servier. B. Neal: Advisory Panel; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Pfizer Inc., Roche Pharma, Servier. Research Support; Self; Abbott, Australian National Health and Medical Research Council, Janssen Research & Development, Merck & Co., Inc., Roche Pharma, Servier. Funding Janssen Research & Development, LLC

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Association Between Gout and Incident Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Cited by 32 publications

References 42 publications

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study

Effectiveness of Statins as Primary Prevention in People With Gout: A Population-Based Cohort Study

1216-P: The Effects of Canagliflozin on Uric Acid and Gout in Patients with Type 2 Diabetes in the CANVAS Program

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